Özer M, Poor Toulabi S, Gijs L, Kreukels B P C, Mullender M G
Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, Location VUmc, Amsterdam, The Netherlands.
Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Location VUmc, Amsterdam, The Netherlands.
Int J Impot Res. 2023 Mar;35(2):121-131. doi: 10.1038/s41443-022-00529-9. Epub 2022 Feb 3.
Sexual-wellbeing is recognized as an important aspect of quality-of-life. Yet, no overview exists of which aspects of sexual-wellbeing have been assessed in trans individuals seeking or undergoing medical treatment, nor is it clear what tools are used to evaluate the effect of medical treatment on sexual-wellbeing. First, to identify which topics pertaining to sexual-wellbeing have been assessed in transgender individuals in a medical context. Second, to determine which tools have been used for measuring aspects of sexual-wellbeing. A conceptual framework of sexual-wellbeing, was used as reference. A literature search (in PubMed, Embase, Cochrane Library) was performed up to March 10th, 2020. Studies that assessed aspects of sexual-wellbeing in transgender individuals' medical context were included in this review. Specific sexual topics addressed in each study were extracted by two independent reviewers. Thematic analysis was performed to identify sexual themes. Additionally, tools used to measure topics related to sexuality in transgender individuals were identified. In 172 papers, a total of 178 topics related to sexual-wellbeing were identified. Ten overarching themes were identified; sexuality, enacted sexual script, sexual activities, sexual relations, sexual response cycle, genital function, sexual function, sexual pleasure, sexual satisfaction, and quality-of-sex-life. Functional aspects of sexuality are assessed most frequently. A variety of methods was used to evaluate aspects related to sexual-wellbeing in trans individuals and over 50 different tools were identified. Self-developed questionnaires were used most frequently (n = 80), followed by chart reviews (n = 50), self-developed structured interviews (n = 37) and physical examination (n = 13). 23 previously developed questionnaires were used, all of which were developed for a cisgender population. Many studies in trans individuals touch on topics related to sexual-wellbeing, however, a comprehensive conceptualisation of (10 themes of) sexual-wellbeing is still lacking. Still, no valid tool exists for assessing sexual-wellbeing in the trans population, but is much needed.
性健康被视为生活质量的一个重要方面。然而，对于寻求或正在接受医学治疗的跨性别者，目前尚无关于其性健康哪些方面已被评估的综述，也不清楚使用了哪些工具来评估医学治疗对性健康的影响。首先，确定在医疗背景下跨性别者中已被评估的与性健康相关的主题。其次，确定用于测量性健康各方面的工具。采用了一个性健康概念框架作为参考。截至2020年3月10日进行了文献检索（在PubMed、Embase、Cochrane图书馆）。本综述纳入了在跨性别者医疗背景下评估性健康各方面的研究。由两名独立评审员提取每项研究中涉及的具体性主题。进行主题分析以确定性主题。此外，还确定了用于测量跨性别者中性相关主题的工具。在172篇论文中，共确定了178个与性健康相关的主题。确定了十个总体主题：性取向、既定的性脚本、性活动、性关系、性反应周期、生殖器官功能、性功能、性快感、性满意度和性生活质量。性的功能方面评估得最为频繁。使用了多种方法来评估跨性别者中性健康相关方面，共确定了50多种不同的工具。使用最多的是自行编制的问卷（n = 80），其次是图表审查（n = 50）、自行编制的结构化访谈（n = 37）和体格检查（n = 13）。使用了23种先前编制的问卷，所有这些问卷都是为顺性别群体编制的。许多关于跨性别者的研究涉及与性健康相关的主题，然而，仍缺乏对性健康（10个主题）的全面概念化。此外，目前尚无用于评估跨性别群体性健康的有效工具，但这是非常必要的。
